Do Women Need Periods?

This post is my rebuttal to all the doctors and scientists who have stood at the podium and tried to explain to a room full of women that menstruation is not natural. Because, they say, our ancestors did not menstruate nearly so often as do we modern women. We should, therefore, be happy to use the drugs of hormonal birth control to shut down our cycles.

Um. Okay.

But here’s the thing. Yes, our ancestors probably were pregnant or breastfeeding a lot of the time and so had fewer periods. But they did have the hormones of pregnancy, which are estradiol, estriol, prolactin, oxytocin, and of course the super-beneficial progesterone. They did not, notably, have the drugs ethinylestradiol, levonorgestrel and drospirenone, which are the drugs of birth control and are not beneficial like our own hormones.

As women, we benefit from our own hormones. That should be stating the obvious, but for some reason, it needs to be said. Women need estrogen and progesterone and NOT just for reproduction. We need them for bones, muscles, metabolism, and mood. We need them for general health. Just as, say, men need testosterone and not just for reproduction. Would anyone honestly make the argument that men need testosterone only when they’re trying to father a child?

We need hormones, and apart from pregnancy, the only way to make those hormones is to ovulate.

Regular, monthly ovulation is how women make hormones. So if we agree that hormones are beneficial, then we have to agree that monthly cycles are beneficial.

It is the cycle that is beneficial. The bleed itself is only an inevitable outcome. Because, in general, it is not possible to ovulate but then not have a period. (The only exceptions being pregnancy, of course, and also the hormonal IUD.)

⚠ Tip: The hormonal IUD (Mirena) is a unique situation. Most types of hormonal birth control suppress ovulation but cause bleeding (the worst-case scenario). The hormonal IUD (Mirena) does the opposite in that it permits ovulation but not bleeding. So, if menstrual suppression is your goal, then Mirena is the only reasonable option. On the downside, the levonorgestrel drug in Mirena can cause acne, hair loss, and depression. See The Pros and Cons of the Hormonal IUD (Mirena).

So. Do we need periods?

No, we don’t need periods if a period is defined as a bleed. And we certainly don’t need pill-bleeds which are nothing whatsoever to do with ovulation or beneficial hormones. Watch Why Pill Bleeds Are Not Periods.

But we do need periods if a period is defined as a hormonal cycle.

And I would invite all women to at least contemplate having a regular cycle. I do understand it is not always easy. Sometimes, as in the case of PCOS, it is difficult to ovulate. Or sometimes, as in the case of the inflammatory disease endometriosis, it is painful and scary to have a period.

I address such problems in my book Period Repair Manualand offer what I hope are possible solutions for almost every woman.

My life’s work is to help women to have easy periods and to, therefore, reconnect women with the hormonal vitality that is their birthright.

Hi, doctor Lara. I suffer amenorrhea amd acne and for that reason different kind of doctors just tell me that the contraceptive pill is the only way to have my period, but I know that the pill is not the solution. Anyway, I’ve been on the pill since 2016 and I want to leave it, but if I do (I tried to) I know I will have worse acne and it will make me depressed. I can´t find doctors like you in my city and I haven’t been able to even find your book. What can I do to have my normal periods back? I have read that I need to check magnesium, zync, etc. Please help me, thank you for reading.

Hello Lara, I turned 50 in April, I suppose you could say I’m in the perimenopausal phase of my life! My periods were regular up until September of this year, I didn’t take a period in October, but I did on the 22nd November and as I’m writing this email I still have them, the heaviness of them is intermittent, I have slight cramping, tender breast etc…but not enough to warrant taking a painkiller! I really don’t want to take any medication for this as I believe this is my body going down it’s natual path, do you have any advice and information that you can give, I would very much appreciate it.

Hi Dr. Lara,
I’ve had a normal period since I was 12 to 14 yrs old. At 14 one day I had a severe stomachache. The scan showed that I had a cyst in my left ovary. The docter subscribed meprate (10mg), 2 times daily for 6 months. After 6 months when I scanned again the cyst was gone. But my periods didn’t come back ever since. And also some parts of my head beacme bald due to loss of hair.

I have consulted many docters. All of them advices me to exercise and maintain weight. I am not obesse. My latest scans shows that my ovaries are smaller than the normal size. I now understand that beacuse of not ovulating my eostrogen and progestron levels are not normal. Thyroids are normal though.

I do get my periods when I had ovral-G. Which was also subscribed by a docter to me. I later found out negetive reviews about the pill. So i have stopped using it. A friend of mine reccomended Vitex and I have used it for exactly 1 month now. But still no sign of a period yet.
I am 29yrs old now and going through one of the depressive experience a woman can ever go through. Which is infertility.

I’m sorry this became very long. But I was really lost until I found out this blog today which resembles so many situations that i am going through. I also have ordered your book.

Docter what should I do? What kind of docter should I consult?. It will be a great help if you could give me an idea.

Dear Dr Briden,
i just finished your book and it really helped me to making a big step towards accepting this hormonal “chaos” (at least that’s how i thought of it before i read your book) which is going on inside my body every month

i’m doing the sport of bodybuilding – all natural of course – and didn’t have my period from may 2016 to sept 2017 due to a far too strict diet.
my question is: in your book you explain that women need carbs – i experienced this too – once i increased my carb intake my period came back. BUT WHAT ABOUT THE FATS? how much fat do women need to keep up their hormonal balance? and do they need more fats than men? some weeks ago i increased my fat intake to 1g per kg body weight

this was the only information i was missing while reading your book … 🙂

Hi Nina,
Thanks so much for your comment. And sharing your experience that “once I increased my carb intake my period came back.”
Yes, women also need a healthy amount of fat including essential fatty acids. There is no set amount like there is for protein. It depends on activity level and appetite and metabolism.

I came across your blog in a PCOS support website. And I can safely say you’ve helped me more than my own physician just by your articles. Now, I have a question that I would love for your professional opinion on:

I became a mom in 2015 and after having him had the DEPO shot because I felt that was a quick option to make sure I did not have any surprises and then decided on the Mirena IUD (with my mid-wife’s insistence on it) for long term use, had it for almost a year when I had it removed and switched for the copper IUD due to the side effects of weight gain, no period, acne, mood swings, fatigue and loss of libido- in other words it affected my life and not in a good way. Now that I’ve had it out for a year now I am still struggling with the same symptoms except having my period back on a very regular cycle. I’ve went over my concerns with my physician and everything was fine but I did have somewhat high testosterone and he made a comment of it being a “mild” case of PCOS and prescribed me Spironolactone (which I only took 2 days and saw your post about it and decided I did not want to risk anymore hormone imbalance) … After reading as much as I could about the condition I am not so sure I fit into any type or phenotype of PCOS because my only symptom is high testosterone. Do you think I have PCOS or just a hormonal imbalance of some sort?

Dear Doc you have brought in light a great topic, but my query is that as you say that women do not really need to bleed, but if this happens won’t it affect our body weight. We had been reading for years that disturbed bleeding cycles are one of the major reason of gaining weight in later years.

Your book and blog have been an incredible resource for me! I’m curious your thoughts on candida and how to get rid of it (is the candida diet necessary, or are supplements and vitamins suffice?)

I took BC for years (and for a few years antibiotics for acne, much to my regret) and still suffer from yeast infections. I am looking for natural remedies to help, as I’ve now been off BC for two years. Any input would be appreciated!

Hi Dr Briden, my 22 year old daughter has just had her 3rd session of a night in Dunedin hospital for what drs have told her is mittelschmerz; ovulation pain. They consider that it is acceptable for her to have to have this happen to her every few months and just come to hospital for the night as the pain is so acute she requires morphine tablets and IV to get a small amount of pain relief. I don’t agree with them and wondered if you could point us in the right direction?

Hello Lara, I would like to know your point of view on the administration of hormones FSH and hCG to ovulate.
I am 30 years old and I lost my period a year and a half ago. I have been with the vaginal ring for more than ten years. The last four, I rested three times to see if my period came back naturally, but it has not happened. The most that I have waited to recover my period is six months, because my gynecologist has recommended me to return to the vaginal ring to have the bleeding. I have been diagnosed with polycystic ovaries (not PCOS). I have follicles in the ovaries, but I can not ovulate. Other doctors report that the problem is hypothalamic.
I’m not obese, I do not have acne or hirsutism. I take care of myself at meals and for a long time I have not eaten meat or fish. Following a visit to the endocrine I have changed my diet and now as meat and fish, and as far as possible I have reduced coffee and sugar. I have a BMI of 18.
A year and a half ago, as I explained, I definitely left the vaginal ring because I want to get pregnant. I waited half a year to see if I would recover the period and nothing. And that is why I started with the FSH administration to ovulate.
The medication really makes me feel bad (headaches, tummy aches, nausea, etc.). I am very sad because I feel that I have not received adequate information about my body, in general, and reproductive system, in particular. I thank you with all my heart for the work you do and I encourage you to continue. You help a lot of people. I wish more women like you.
Thank you very much,
Susana (from Barcelona)

Hi Susanna,
You should be able to ovulate on your own without those fertility drugs. The key will probably be to eat more including meat and starch like potatoes. And even once you start eating more, it will take a minimum of 3 months to ovulate. Because, as I explain in my book, it takes 100 days for an ovarian follicle to ovulate. You may also benefit from zinc. Please see my new book including Chapter 7 where I discuss hypothalamic amenorrhea.

I am having a hard time with Vermont laws allowing minors to be able to make their own choice regarding birth control. I truly understand why we have these laws but do not understand why there aren’t provisions in the laws…especially for parents that are allowing their young teens to have an IUD, but also want to make smart choices for their daughters. Let me explain my situation. I have a 15 year old daughter that wanted to go on birth control…much to my dismay she is sexually active. She started her period very young, around 10 years old. She had irregular periods for not quite a full year but then went into amenorrhea for about two years. She was referred to an OBGYN, but just as the appointment approached she got her period back around 13.5 years old. I kept track of her periods for about a year and a half and they seemed pretty regular. Now comes the request by my daughter to have an IUD. We made the appointment with my OB and sat through all the options available. My daughter wanted to go with a hormonal IUD and I wanted her to do the Copper IUD, ParaGuard as I don’t think kids should be on synthetic hormones…especially my daughter since she had a history of issues. We left to think about her options and made an appt to have an IUD inserted. I was thinking about what the OB said about measuring my daughters uterus to see if the larger IUD would fit…especially since the Copper T only comes in the larger size. My daughter decided on the Kyleena and I was upset with her decision. I called the office the day of her appt to say that I think we’ll go with the Copper IUD. When we got to the appt the doctor asked me to leave so she could talk to my daughter alone. When I was out of the office I was wondering if the doctor would lie to me about the larger IUD not fitting in my daughers uterus. When I was asked to go back into the room the doctor basically offered the fact that she would not want to “tell me the larger unit wouldn’t fit so my daughter could get her choice”…that it was my daughter’s body and her choice ONLY. It’s not like I was interfering with my daughter getting birth control but I wanted her to get one that was safer, in my opinion. So my daughter had the Kyleena inserted and out of the office we went. A few days later I read your article about why young teens need periods not the pill. I agree wholeheartedly with this article. I often wonder when these hormonal IUD were first starting to be used in young teens. I know research shows that women that have had these IUD’s are able to get pregnant after removal of the IUD. Have young teens been having these hormonal IUD’s long enough to know that these young teens do not have issues as young women trying to get pregnant?

I inadvertently left out a couple key points to my story. A month after my daughter had her Kyleena inserted I had a weird period that was virtually not a period at all…then two weeks later I had the most awful period ever…I had to change my super plus tampon every half hour for two days. Why can minors make choices that affect the other women in the household?! I never signed up for her hormones to affect my cycles. The other point I forgot to mention was at the time of my daughter’s appointment to have the IUD inserted, once the procedure was done the doctor handed me a “card” with the expiration date and serial # of the particular IUD residing in my daughter’s body…I told her that she should be giving that card to my daughter, not me, since she is the “responsible” party that can made good choices at age 15! It really bothers me that young teens can decide to be sexually active but have no responsibility for their choices/actions!!!

Can Garlic capsules be used instead of Oregano? Oregano really hurts my stomach. I haven’t tried Garlic, but I imagine it may hurt as well. What do people with sensitive stomachs do for Candida and SIBO?

Hi Lara. Just bought your book on periods to better understand my 19 year old daughter’s amenorrhea/aggravated IBS on the OCP/evidence of PCOS. Very helpful! Is there a brand of magnesium you like? Think we’ll start there.

Very interesting! I do also think ovulation and menstruation are beneficial for women. Just one thing: after menopause you don’t ovulate anymore. I’ve 54, and I’ve been two years without my period. I have good health, I sleep well, have a good libido and good lubrication, good weight , good skin and no hot flashes or mood swing. I look much younger, I eat plenty of vegetables and no meat and I use to do exercise like yoga, dance, hiking and walking. I don’t take any kind of hormones.

The ovulations and hormones of our younger years are like deposits into a “health bank account.” So that when we get to menopause we have a good reserve of bone density, muscle mass etc to carry us through the last 3 or 4 decades. And Yes, it is definitely possible to be healthy after menopause. We can’t make the same large amounts of estradiol and progesterone but we still make some–both from our ovaries and also in all of our body’s cells from the precursor hormone DHEA (from the adrenal glands). And also our hormone receptors re-calibrate and adjust to the new normal lower level of hormones. I discuss the menopause transition in Chapter 10 of my new book.

Hi Lara, I was wondering what your views are on the pill as a last resort to maintain bone density if a woman can’t have natural cycles?
I’m 32 and I lost my periods 8 years ago. I have been on and off the pill since then, but I came off it 8 months ago with the intension of staying off it permanently, because I have read so many negative things. But I haven’t had a period since then and my oestrogen is low. My gynaecologist says I don’t have PCOS or early menopause. He thinks the problem is hypothalamic but he can’t say why I don’t ovulate. He strongly recommends the pill for my bone density and I have to admit that I am worried about osteoporosis, as all the older women in my family have suffered from it.
I’ve read your book, but I’m still at a loss about why I don’t ovulate. I used to run a lot and calorie restrict at the time when I first lost my periods, but I stopped that years ago and I have a healthy BMI of 19.5. I considered vitex but my prolactin isn’t high so I don’t think it will do anything.
Do you have any recommendations other than the pill for maintaining bone density? Obviously the best answer is to ovulate, but I don’t know if I can.
Thank you.

I assure you that you can ovulate. 🙂
Your problem before was that you were under-eating. Your problem now is the very common and normal problem of post-pill amenorrhea. In the new edition of my book, the first patient story is Christine, who takes one year to get her periods back off the pill. IF you are eating enough, then you may just need more time. By “eating enough,” I mean solid meals that include meat, chicken or fish PLUS starch like rice or potato.
Also, it’s worth noting that the pill does NOT actually help bones: https://www.ncbi.nlm.nih.gov/pubmed/18180975/

Good Night, my name is Natalia , I have been diagnosticated with PCOS bit I always hace vas my period regurarly. My ginecologyst give me fue pill for “controlling” my acne amd hair loss but is not working, instead my emotions are down. I recently discover that I can controle the symptoms through the way I eat. I would like to read your posts for more information. Thanks 🙂

Phew.. I am so glad that you wrote this article. I went in search for your website literally just to find this very article. I have read your book Period Repair Manual, and it has helped me tremendously. The reason I was searching for such an article is, I came across a LEADING danish female gynechologist that just stated that the only two periods a women really need, is the two she must have in order to conceive her two children (!!!!!). I am absolutely, positively steaming inside!

I was put on birth control as a 17 year old, and was on them for nearly two decades, without anyone trying to figure out WHY I had such a problem with acne to begin with. I think the job you are doing is phenomenal, and I just wanted you to know that.

I finally am understanding your *cheers* for ovulation, 🙂 particularly after hearing you speak yesterday, and reading your book. I do appreciate, in instances of endo, that you acknowledge there may be a need for the pill or IUD.

You replied to me yesterday in your Facebook live, and though I am terrified to take the progestin only pill (esp.after learning about the side effects of mood you mentioned. 🙁 My Dr. didn’t mention this concern at all! [she put me on this one b/c I also suffer from migraines occasionally and didn’t want the estrogen + my age (48) to possibly cause stroke]), I can understand why I have to do it now, but am not happy, and scared also to become depressed among other concerns. I do think I will add in the micronized progesterone, as you have mentioned, and hope for the best.

I already do all the gf, no dairy, anti-infl. diet and am generally healthy.

Thanks for sharing your story, Nina. As I mentioned in the Q&A, progesterone can, in theory, be used together with a progestin. But it can also work on its own for both endometriosis and migraines. Chapter 9 of my new book includes a patient story who used micronized progesterone for endometriosis instead of the progestin Visanne. Please also see my endometriosis post for information on turmeric and other medicines.

Thank you for your reply. The pill is of course my last resort, after literally years of trial and error with all things natural, etc. to no avail. I never tried just progesterone though. When I decided to try the pill again, the Dr. automatically noticed in my chart that I get migraines and explained the risk of other pills (with estrogen), and suggested the progestin option due to stroke risk. I really have no other choice – and have literally run out of time if I want to keep a job – to even try the progesterone cream alone. Here’s to hoping this pill work, or I go into menopause. I figure this is at least better than the Lupron option, which she also proposed and I said NO WAY. It’s been a helluva ride. I still have to get the updated book! Thanks again. Frustrated but carrying on.

Hi, Lara. In your book you write that Resveratrol lowers Estrogen. However, Harvard Health Publishing says high doses actually increase Estrogen. Do you know at what dose it increases Estrogen? Thank you!

Do you have a link for the Harvard publication and the reference? I’d love to take a look. And it wouldn’t surprise me if high-dose has a different effect from low-dose. That’s true for other herbal medicines. The standard dose of resveratrol is 200 mg or less.

Lara, what is the cause of very light spotting about a week after your period ends? Not enough for you to notice in your underwear, just while urinating? This has happened to me the past 2 months and never before so it kinda freaked me out.

Fair enough, but there is also the possibility that progesterone helps to prevent breast cancer.
But still, you probably do want to work to reduce estrogen as much as you can. Please see my Estrogen Excess post if you haven’t already.

I totally and 100% agree with you. I am 54 and I instead to keep my period as long as I can. I keep going to my doctors as part of my regular check ups and defy the odds of getting early menopause because I still get a month period effortlessly. I am a nutritionist and I know that there are so many health benefits to having a monthly period than not that putting up with a few days of bleeding still proves the anti-aging and hormonal changes my body requires to be healthy.

Lara, I tottally agree with you about how bad those drugs are.
But I’m not happy with my 8-9 days painful period. And I’ve considered taking natural herbs to increase my testosterone to the point of stopping it. I’d like to hear from you what you think of it!

Of course, a painful 9 day period is not something you should have to put up and it’s not normal. Have you had a diagnosis? Please start with my post When Period Pain Is Not Normal, and then leave another comment there.
And no, it will not work to take natural herbs to increase testosterone and stop your period.

I’m excited to try these 3 months of dairy free diet + supplements! I’ll come back to tell you how I felt! (although it’s a long period, reading your article it seems to me to be a normal period pain).

I’m interested on testosterone because I’ve been reading about it’s effects and it looks like everything I ever needed: stop periods, gain of muscle (I’m very thin and loose muscle quite easily), even gain of spatial intelligence (has always been so hard for me to drive or example). So I started taking Tribullus terrestris. But I’m considering to have bio identical testosterone (gel) too. What do you think of it?

Hi Lara, I’ve seen you recommend a few times to find a herbalist or naturopath to help carry out your suggestions in the period repair manual as you can’t diagnose over the internet. How do I do this? Should I take the book to the naturopath and ask them to follow it? How do I know they’ll prescribe the way you would?

Lara I love your blog posts, thank you! I would love to hear about hormones and migraines. My migraines come at certain times of my cycle and are linked to hormones, I would love to hear your thoughts in a post sometime! Xx

Hi Lara. I hear you Gracie, I too experience day 27, 28 and then day 1 headaches as my hormones plummet and bleeding commences. I’d love to learn more about it too. Many thanks for your wonderful work Lara xo

Lara, you seem to be implying there is no benefit to the bleed that follows a cycle. However, I am under the impression we need to shed our uterine lining to keep our uterus healthy and prevent it from “building up.” Is this not true? I feel mother nature usually gets it right and the bleed would not occur if not for a reason. I understand and appreciate your mission to hone in on the importance of the hormones and to emphasize that periods are not just bleeds as we are brainwashed to believe. I understand this issue takes strategic focus to get the point across, but please clarify that the actual bleed does have importance.

Hi Beth,
Thanks so much for your question. You have brought up an important point that needs clarifying.
Ovulation will always lead to a period because progesterone-withdrawal triggers the shedding of the uterine lining. That’s a good thing because without progesterone, then estrogen will just continue to make the uterine lining thicker and thicker, and that can increase the risk of uterine cancer. Estrogen but no ovulation (and no progesterone) is what can happen with the anovulatory cycles of PCOS. And so that’s why doctors will say PCOS-sufferers need to take something to induce a bleed. (Of course, the better solution is to establish regular ovulation to make progesterone to promote a real period.)

In other words, if we’re going to make estrogen, then we need to get all the way to ovulation to make progesterone to “balance” it and shed the uterine lining.

Once again, my emphasis is on ovulation and progesterone. They are beneficial. And the period is a necessary and beneficial outcome of that.

Thank you for clarifying. If I understood correctly, we do not need to bleed and shed our uterine lining to keep it healthy, but we need to have Progesterone to balance Estrogen’s effects on the uterine lining to keep it healthy? I accept this. Thank you again.

Hi Beth,
If there’s build-up uterine lining under the influence of estrogen, then it needs to be shed.
But if there’s no build-up of the uterine lining (as in a low estrogen situation such as breastfeeding), then the lining doesn’t need to be shed.
Another common low estrogen state is undereating or anorexia. In that situation, there is a real need to ovulate and make estrogen and progesterone (for the sake of bones and brain and health), but not a need to shed the uterine lining (because it hasn’t built up).

Hi Laura,
On this topic, I wanted to ask you how long I should wait to induce a period by taking progesterone such as Prometrium if I haven’t had a period in a few months due to PCOS. I have just read your book and am trying the herbs you recommended for my post-pill PCOS but I haven’t had a period in 5 months. Should I give the herbs a few more months or take progesterone to induce the shedding of my lining to prevent too much build up?

I have written in a few times before and I need some serious help regarding hair loss. I have androgenic alopecia. I am also insulin resistant, overweight and prediabetic. My hair WILL NOT grow anymore. I just started taking dutasteride today. I have elevated dht but all my other hormones are normal. I was told that my dht is too high by a hair loss specialist. My own doctors say its in a normal range but they don’t seem to know much about it. The hair loss specialist is somewhat confident that the medication will stop the hair loss but they make no guarantees of this nor that my hair will ever grow back. I have quit sugar and grains. Can you tell me if I can expect my hair to regrow from these dietary changes? Have you had any patients at all who were ablw to grow their hair back? I have tried minoxidil, and a few other hair growth stimulators as well as a laser helmet and my hair has only gotten worse. The entire front of my head all along the hairline, temples and sides is stuck , not growing. Please advise. The dutasteride is to lower dht. I had no choice but to go on it. It is a small dose once a week. I probably have pcos, BC insulin is over 14 and I had an ultrasound that showed cysts a few years back. Please advise if I can regrow my hair and how long it will take.

I have not had hair loss but have seen an increase in hair growth and nail growth consuming beef collagen daily. I use Vital Proteins blue container – but they have many options. Blue container does not congeal and I put a scoop in my morning cup of tea. You don’t even taste it and it starts to create growth in a few short weeks. You can find VP on amazon or their own website. So sorry to hear of the hair loss and I hope VP collagen helps you!

I also have a hair loss problem. I’m 46 and my weight is normal. I don’t eat any kind of sugar, fruits, processed food, gluten, grains, pops, juices… I mostly eat meat, healthy fats and vegetables. I take magnesium and use natural progesterone cream. My hormones are normal. I don’t have periods any more. I don’t have PCOS but my hair is still falling out. Please help!!!

The androgenetic hair loss caused by insulin resistance is not easy to treat or reverse. The first step is to reverse insulin resistance (please see my post How to Reverse Insulin Resistance). That can take six months. And THEN, you have to make sure everything else for hair is in place (zinc, iron, optimal thyroid function, regular ovulatory cycles as discussed in my Hair Loss post), and THEN you should start to see an improvement after another six months. Keeping in mind that the miniaturization of hair follicles is not always reversible. So you may not be able to recover all your hair. (I’m sorry to be the bearer of bad news, but as I said, this kind of hair loss is not easy to fix.)

Lara, I am scared to have a period because I have endometriosis. I recently after MUCH hesitation and trying all natural suggestions (mostly found here) have gone back on Lutera (a birth control pill). I took it before but stopped due to side effects. Those side effects now are less concerning than a monthly period – for one, I couldn’t work with the pain of endo. I am mostly concerned b/c I am 48 – and to be taking birth control at this age is concerning. What do you think about older women taking it for endo? Please reply. Also, do you have advice to combat the side effects, such should I still take turmeric, or work on improving on my gut health etc. Looking forward to your insight. Thank you

I agree with Alexandra that the best treatment for endometriosis is a properly done excision surgery. Possibly followed by the Mirena IUD.
But if the Pill is actually helping you, then that’s what you need to do. There’s no way to reduce the side effects of the Pill but you can still use the natural anti-inflammatory treatments for endometriosis (dairy-free, turmeric, zinc) to try to calm the disease and hopefully ease your transition off the Pill at some future date. The good thing about being 48 is that menopause can’t be far off. The tricky thing might be menopause itself because you probably won’t be able to tolerate estrogen HRT (as it can aggravate endo), but you might get some benefit from micronized progesterone. Please have a look at Chapter 10 in my book which is all about the menopause transition.

Hi! I love your posts, first of all. Love love love. What advice do you have for people new on plant based diets, who want to keep a healthy regular period? My sister and many friends lost their periods for over a year now.. oh my words. This, and hair loss is something I’m so paranoid about lately- I just don’t want to screw up my body/hormones. I have a healthy period right now, aside from endometriosis. Also… do you have any expertise on the product Endovan? I’ve heard it really helps with endometriosis. Thought I’d ask the best! 😀

I’ve heard good things about enzyme supplements for endometriosis. I haven’t yet started using with my own patients but I think I will.

As for a plant-based diet, I’ve been trying to think of a way to say this that will not upset people. I truly do not think that veganism is conducive to long-term health. It can be okay in the short term and can reduce the inflammation of endometriosis but mainly because of the no cow’s dairy part. My approach is to remove cow’s dairy and sometimes eggs (because eggs are a common food sensitivity) but to ask my patients to continue to eat nourishing animal foods like lamb, goat cheese, chicken, and fish. That way, I know they’re getting the nutrition they need. And the nutrition their immune system needs. Because I am convinced that endometriosis is an immune disease. And it does not help to starve the immune system of the protein, zinc, selenium, vitamin A, iodine, omega 3, and vitamin K2 that can really only be obtained from animal foods.

Good to know goat cheese is okay! Bc it’s so hard to quit dairy altogether. I am one whose doc said to go vegetarian/vegan and I can’t personally sustain it anyway. I like eating meat, fish, etc too much, and continue to do so – BUT am trying to eat more vegetables and less protein w each meal bc I’ve been told that without my gallbladder, my body does not digest protein well, and maybe have read on your blogs (or elsewhere) that excess protein does also turn into sugar/fat storage (maybe that was a pinterest post now that I think about it).

Hello Lara, what an informative post! What about lactating women? Is it healthy to go months on end without a perios due to lactation amenorrhea? Is this in the same “exception category” as pregnancy that you mention above? I’ve not had a period for 5 months as I am exclusively breastfeeding my baby who knows how long I’ll go without a period!

Great question. I thought about addressing breastfeeding in the post. The hormones of breastfeeding are prolactin and oxytocin, which are natural and beneficial. It’s fine to go without a period while you’re breastfeeding. (And it’s very different from being on hormonal birth control.)

I have PCOS and Hashimotos, have been off the pill for about 3 years and suddenly have not had my period in 103 days. I turned 39 in July and have no children and know I’m not pregnant. I became obese after an 80lb weight loss (paleo diet only) in 2010 and having my gallbladder removed shortly thereafter. Am being told I’m unable to eat anything but vegetables. I can’t seem to lose weight through diet or exercise; admittedly incredibly difficult to exercise at this weight. I’m taking inositol and magnesium to help bring on my period. I read on your blog that progesterone is not good for insulin resistant PCOSers so stopped taking vitex about 3 weeks ago and switched to the magnesium. Been taking inositol for several months. How long will it take to get my period to start again? Is it the weight that keeps period at bay?

I see a new obgyn in October and don’t want her to force me to get back on the pill OR take progesterone. Is there anything else I can do to start my period while I continue to try ways to lose weight?

Hi Laura,
thanks for sharing your story. I did not say that progesterone is bad for PCOS. Progesterone can be very good for PCOS, as I explain in my new book. But Yes, I did say that the herbal medicine Vitex can worsen some types of PCOS. (And also, please understand that the progestins prescribed by most doctors are NOT progesterone. Please read the Crucial Difference Between Progesterone and Progestins)

Who is telling you to eat only vegetables? If you have insulin resistance, then you need regular protein, together with strictly avoiding all dessert-type foods (including dates, paleo squares, bliss balls, fruit juice etc). Please see Chapter 7 in my new book or my post How to Reverse Insulin Resistance in 4 Easy Steps.

Your doctor will likely want you to take Metformin, which can also be helpful

A doc I paid a lot of money to see – chronic condition specialist – told me my body only digests fats and vegetables without my gallbladder. That I need to become vegetarian. Later said I need to “keep eating keto” which is advice he’d not given me before.

I don’t want to take metformin again. It’ causes diahrrea immediately after meals. Do you know of an alternative? Also what else can I do to get my period back?

Your doctor said to “keep eating keto”? That’s the opposite of a vegan diet. I really can’t see how you make any progress with insulin resistance on a vegan diet. You could look at using enzyme supplements to help you to digest fats, but please speak to your doctor.

Yes, he’s been very confusing and I’ve stopped seeing him bc of all the money it was costing me ($4K in 4 months) and zero results. I continue to try to find a doc who can effectively help me here in Delaware, USA, but in the meantime, eating paleo, but w heavy emphasis on vegetables and smaller protein portions at each meal, your FB and blog are essential and enlightening. Also really trying to begin walking more, albeit hard at my current weight. Sedentary job, and constant fatigue don’t help either, but I really want to get well. Thank you.